Fiscal, Health Policy Malpractice

Just when you think Gov. Mary Fallin and legislative leaders couldn’t top last year’s display of fiscal and health policy ignorance when they rejected – under pressure from some foaming-at-the-mouth Tea Party members – $54 million dollars of OUR federal tax money to fund an Oklahoma run health care exchange … they have.

As a reminder, this PRIVATE insurance exchange would have been available to our poorest adults and some children. We even have a fine entity called Insure Oklahoma that could have been the blueprint for our very own state program at least until 2014 when the federal waiver for its existence expires.

Still, since the money to fund Insure Oklahoma comes from a share of the November 2004 VOTER APPROVED $1 per pack tax increase on cigarettes, the revenue derived continues even after Insure Oklahoma sunsets and, most importantly, IT MUST BE SPENT ON HEALTH CARE FOR OKLAHOMANS.

So just how could these elected officials be even dumber than this earlier dumb-off in 2012 when they, in effect, sent our $54 million in tax money to OTHER states to fund their health needs? Naturally Ding Dong Decision No. 2 relates to the same federal legislation affirmed by the United States Supreme Court and otherwise known as the Affordable Care Act of 2010.

To its enemies, and they are legion especially among Republicans, the landmark legislation also carries the pejorative moniker ObamaCare, the most hated word in the Grand Old Party’s limited dictionary.

Most damaging for at least 200,000 of our uninsured citizens [those making less than $23,050 per year for a family of four] is Fallin’s rejection of an expansion of Medicaid coverage and thus it qualifies as the even dumber political ploy.

Simply stated, turning her back on the Affordable Care Act steals from our poorest and sickest citizens health insurance. Remarkably 100% of the money to fully pay for this additional health care comes from the federal government through 2016 and then 95% until 2020, SEVEN LONG YEARS FROM NOW.

In 2020 Oklahoma’s state share would be $22 MILLION, a pittance as measured against the $3.6 BILLION in Medicaid money that would have been received from the federal Department of Health and Human Services.

In the history of our state, this edict by Gov. Fallin is the single most moronic act by an Oklahoma chief executive, perhaps only topped by the certifiably insane Gov. Alfalfa Bill Murray’s order to call out the National Guard and threaten to shoot Texas officials at the Red River bridge during a squabble in the 1930s. At least during that ignominious ass-showing no one got hurt.

Unfortunately for tens of thousands sick, disabled or dying men, women, and children – those accurately identified by Oklahoma Policy Institute Executive Director David Blatt as living in a crater devoid of any hope of health coverage – Fallin’s decree means they now face, and due to no fault of their own, life and death decisions that could have been completely avoided with mature, informed leadership in the Capitol.

Having made such a damning statement about the current ruling political class, some readers – and rightfully so – are perhaps saying to themselves, “Prove it, Hobson.”

OK, I can and will.

First, before I explain the real reasons behind these regrettable rejections of health care money I must reveal the fallacies behind the empty excuses, devoid of fact or common sense, offered by Fallin for her actions. We’ll take them one at a time.

1. As to turning down the exchange money in the spring of 2012, after initially accepting it, the chief executive declared that evil ObamaCare would, in effect, write the rules, AT LEAST TO SOME EXTENT, even if the state developed its own plan using the aforementioned Insure Oklahoma framework.

Therefore, the governor declared that, should the Health Care Act be found constitutional by the Supreme Court – which she doubted due to legal advice and political cover provided her from the extremely conservative and ambitious soul-mate, Attorney General Scott Pruitt – she still would prefer to see the federal bureaucrats author our ENTIRE PLAN rather than having fully qualified Oklahoma health experts create it.

Why? Because then she can’t be blamed for the implementation of ObamaCare, notwithstanding the good it would do for thousands of her most at risk constituents.

Also, acceptance of the expansion would have prevented the loss of enormous federal money to Oklahoma’s hospitals under the program known as DSHS, or Disproportiament Share Hospitals. They desperately needed these DHSH revenues to cover just some of their heavy financial losses due to uncompensated care which, by law, they must provide.

Chief Justice John Roberts cashiered her expectations from The Supremes when he wrote the opinion upholding the act. However, he also penned that states could choose to turn down the Medicaid expansion.

Therefore, in November 2012, even after the presidential election and Supreme Court decision, Fallin and a slew of other Stone Age Republican governors, while attending their annual national confab in remote and nothing-to-do Las Vegas, repeatedly intoned their fiscal bonafides while attacking the federal law.

Of course, it didn’t take much arm-twisting from the likes of former Republican Gov. Haley Barbour of Mississippi to persuade Malleable Mary to reject the large and desperately needed Medicaid help for our citizens.

However, and most amazing in light of tight-fisted Fallin’s oft announced disgust with federal money, she concurred in the signing on Jan. 10, 2013, of a $500,000 contract by the Oklahoma Health Care Authority, fully half of which will be paid for by the hated federal government.

The work to be performed, as reported in The Oklahoman, is for an out of state firm to “study the Oklahoma Medicaid program.” And just who is the recipient of this completely unnecessary waste of taxpayer money? Why, of course, it’s one of her Republican buddies, former Utah Gov. Mike Leavitt, self appointed health care expert and vocal opponent of the ACA. Leavitt who is now employed in that second oldest profession plying its trade in Washington, DC – influence peddling.

By the way I’ve met the good governor and he is a fine fellow but – come on! – a guy’s gotta eat properly, unlike so many poorly nourished Okies.

The study, I predict, will say that Oklahoma has very low Medicaid reimbursement rates for recipients, hospitals and doctors. It will also point out we have the sixth highest rate of uninsured citizens in the country; that we drink, smoke, abuse legal and illegal drugs excessively and are obese far above the national average, and that we die in Oklahoma at an earlier age than any other state’s residents in the union except two: Alabama and Mississippi.

There. Where’s my cut of the contract?

Regardless of this cozy deal, the question remains: why in the world would any thoughtful leader in this health care-starved state bar coverage for 200,000 mainly working adults, when fully 95% of the expense for their care would come from Washington?

The answer, my friends, is painfully simple: Politics. If a Tea Party wingnut of some stature strikes a match, let’s say in the Panhandle, our self-described, extremely conservative first female governor feels the heat and immediately caves.

I know this drill intimately and a short story will illustrate it for you. One Thursday while serving in the House of Representatives, way back in 1983, I had a bill scheduled to be heard. However, we ran out of time that day and the floor leader promised my proposed legislation would be first on the agenda the following Monday.

No problem, I said, since I had done my homework, including running a roll call, and had the necessary votes for passage. Monday arrived, my bill passed, but a fellow Democrat from south Oklahoma City who had promised to vote for my legislation not only voted NO but debated against it.

Naturally, I queried this individual as to what had happened to his YES vote over the weekend. His reply, verbatim, was “I was just inundated with calls asking me to oppose it.”

And how many calls was that, I asked.

“Five”, he replied.

He represented 28,000 plus folks but five is all it took for his backbone to turn to jelly.

Same thing concerning the Medicaid expansion happened to the current resident of the Governor’s Mansion. Thus, after brief consultations with leaders in the House and Senate, our billions of tax money will now flow to New York or some other more progressive state providing health benefits to their residents.

Let’s hand it to these freedom-loving, government-hating zealots who dominate the Tea Party. To paraphrase Winston Churchill, never have so few done so much damage to so many.

Often, after participating in their Capitol rallies, where rampant ignorance, some degree of bigotry, and pure silliness pass for patriotism and wisdom, many then go cash their Social Security checks, head to the doctor for Medicare paid treatments, and finally schedule a stop at the pharmacist to obtain expanded prescription benefits authorized by a Republican Congress while being urged on by that well known budget conservative, President George W. Bush.

Of course, these newly available and expanded pharmaceutical drugs, designed to fill the now famous donut hole, were NOT paid for – but simply added to – the national debt by self identified fiscal watchdogs that Tea Partiers claim to adore.

2. Let’s now explore the BIG DEAL – that being the rejection of the $3.6 billion Medicaid expansion.

Fallin and her secret advisors on this decision – secret since she will not release some internal PUBLIC RECORD e-mails from them as she reached her terribly wrong-headed conclusion – explained there were at least two major reasons for her honor’s decision. Both are NOT TRUE.

First, our mathematically-challenged occupant of the second floor governor’s office said the state dollars needed to match the federal outlay over the next seven years would be $475 million bucks. If true, that could be a salient argument for just saying NO. Unfortunately for the Fallin gang, ALL reputable studies show no new state Medicaid dollars are required until 2016 and then it is only $17 million growing to approximately $22 million in 2020.

Budgeting for these modest increases in the STATE match during future years is and will be available from the aforementioned cigarette tax earmarked for health care. No general revenue is needed but if it was, nearly $600 million dollars of your money sits unused in the state’s Rainy Day Fund.

Obviously, the governor has a Mary Poppins umbrella and doesn’t know that it is raining a downpour on thousands of her most health-deprived constituents. After all, she reasons, these folks are so poor they can’t possibly make campaign donations for her re-election in 2014 and many of them, probably a majority, will vote for her anyway even if out of ignorance.

The Tea Partiers, her base, plus the great unwashed, the state’s largest voting bloc, guarantee re-election and perhaps in a cakewalk.

Even if the CEO of the state had wanted to accept the additional Medicaid money, which some of her supporters claim, that progressive instinct was exorcised in a meeting at the capitol with the then-House Speaker-elect, T.W. Shannon, R-Lawton. This come-to-Jesus lecture came ON THE SAME DAY of the organizational meeting of the Republican caucus in November 2012.

Shannon advised Fallin that the new and even more conservative [however impossible that may sound] House members just elected were not interested in anything with the word ObamaCare in it, even though to accept the Medicaid money, the members of the lower body have to do NOTHING but simply let a rule from the administration move forward without rejecting it.

Speaker Shannon reaffirmed his disgust with Obama AND the Congress during his acceptance speech on Jan. 8 when he opined, “We live in a country with an out-of-control federal government that is bankrupt financially and morally. As a result, we have fewer freedoms, we pay more in taxes than we should, and there is little hope of these things changing under our current president and this Congress. So let me say this: In fact, we will push back at every turn. We will fight every invasive regulation. We will refuse each costly expansion.”

Great applause lines.

However, the speaker’s remarks ring hollow, especially as to his disdain for $$$$$$$$ from the U.S. Congress, since he has been on the federal teat most of his entire adult life courtesy of Oklahoma Congressmen J.C. Watts and Tom Cole.

Following her conversation with the newly-minted speaker, where she was told how things would be in the 17th Century House of Representatives, Fallin trotted out one more lame excuse by positing she was sure the duplicitous President Obama would change the formula in the Medicaid match during future budgeting cycles, thus increasing the costs to the states.

That possibility could easily be addressed by writing into a state statute that Oklahoma would trigger an opt-out option should the feds double-cross us. Additionally, Oklahoma is not an island – and unlike the dunderheads to the south in Texas, we have no plan – yet – to secede from the Union.

A change in the Medicaid matching formula would impact all states, the Congress would have to pass a bill to authorize it, and Obama would need to provide a signature.

After all, whether a bunch of Okies hate ObamaCare or not, and they do, the Affordable Care Act is his most prized victory from the first term, has been declared constitutional by the highest court in the land, is being implemented in logical coherent stages over this decade, and thus the current occupant of the White House would be the last person on earth to support repealing any or all of it.

Yet its rabid opponents – such as AG Pruitt, Mike and Mike of the House of Representatives [surnames being Ritze, from Broken Arrow, and Reynolds, from South OKC and whose constituents surely could provide intellectual upgrades next election cycle by sending monkeys instead] – continue to beat this dead horse ranking them at the very bottom, along with Kennedy assassination theorists, in understanding reality and fact from mythology and myopia.

This particular horse has been long dead, shipped to the glue factory and has now sold out on the shelves at your local hardware stores.

Time for the naysayers to move on to some other hair-brained concept, perhaps along the line of where the president was born. Oops, been there done that.

Obama won massively in the Electoral College, 332 to 206, and is the first president since Eisenhower in the ‘50s to win two consecutive terms with more than 51.5% of the popular vote. The rich guy from Massachusetts [I can’t remember his name], who has plenty of health insurance for his family, lost.

Therefore, this bogus argument about formula change is completely without merit, as the leaders surely must know, but they also think Okies are so dumb we don’t.

As the federal law moves to full implementation in 2014 and beyond, its rejection may be a decision Fallin will come to regret, although too many of our citizens make it an art form to vote against their own best interests – over and over again.

3. The other fig leaf [the image is disturbing] for refusing new Medicaid money is … drumroll … the out-of-control federal debt, now exceeding $16 trillion, a number I cannot comprehend.

Both parties in the Congress, and all presidents going back to, but not including, Bill Clinton, whose administration produced a series of balanced budgets in the early ‘90s, are culpable for loading down future generations with the profligate spending on themselves and ourselves.

As to ourselves, we’re also to blame for this fiscal insanity since we generally re-elect those who have brought us to this spending crisis.

Speaking of insanity – the definition of which is doing the same thing over and over but expecting a different outcome – I’m convinced we need dramatically more mental health care than anyone in this treatment wasteland of a state ever imagined.

As I’ve said, this final handful of Jello being tossed against the wall of reason and hoping it will stick is of course the professed alarm about the mountain of debt residing along the Potomac. This alleged impending apocalypse, much like the prediction in the Mayan calendar about Dec. 22, 2012, is also phony.

Two wars have been fought by our bravest men and women over the last 20 years and all their costs under President Bush went against the national debt. Combine this with the continual raiding of the Social Security trust fund to pay for ongoing expenses dreamed up by the boys and girls in Washington and you soon realize they are not fiscal hawks but, with few exceptions, just chicken hawks.

Our $3.6 billion of never-to-be-received tax receipts – paid by us to extend health care for the working poor – will NOT go to reduce the debt but, once again, flow to the other states whose citizens for the most part are not as sick as our 630,000 plus uninsured souls.

Therefore, due to idiocy currently reigning in the state Capitol on the second, third, fourth, and fifth floors, we not only lose our tax dollars to unknown places outside our borders, we get to pay TWICE for the privilege because our sick will still eventually wander into emergency rooms, receive the most expensive form of health care, at the last possible moment, and we get to pay for that too – in our increased insurance premiums.

The added cost to us – the so-called Solvent Sick – is approximately $1,200 per year and could have been largely avoided if anyone, just ANYONE with an “R” behind his or her name, was thinking seriously about health policy in Okieland. But no. ObamaCare remains the most despised word in the Sooner state, especially by the Tea Party goofs, but joined in as well by too many of our ill-informed fellow residents who would benefit the most from its full implementation. These folks are your neighbors who toil away at Walmart, fast food places, and convenience stores, often working two or more part time jobs just to make ends meet.

By the way our governor proved on Jan. 9, during a speech before the National Press Club in Washington, that she is not genuine in her oft-state worry about the federal debt.

Among her comments that day, Fallin urged the Congress to NOT cut its allocations for state budgets and programs which – and since Oklahoma is a NET recipient of federal largesse, especially on huge military outlays – would dramatically damage our state.

Her comments were nothing more than a modern restatement of that ancient admonition from the original Kingfish, Gov. Huey P. Long of Louisiana, when he uttered the following imperative about spending:

“Don’t cut me and don’t cut thee, cut the man behind the tree.”

All politicians are looking for that man but won’t find him simply because, as Pogo explained, “when looking in the mirror we see the problem and it is US.”

I know that is not an exact quote from the Wise One but you get my point.

Speaking of points, and this is my final one, our allegedly frugal governor enjoys generous health benefits, paid for by the taxpayers, just like that received by many members of America’s self-described most conservative lawmaking body, the Oklahoma Legislature, which, besides being nutty backward, is also the 11th best paid legislative body in the entire land.

Hmmmmmm … do as I say not as I do, perhaps?

By the way, let’s hope our solons had a great time at the just-held Speaker’s Ball on Feb. 1, which was mostly paid for courtesy of hundreds of lobbyists. The profits derived from the gala event are earmarked by new Leader Shannon to recruit foster families, a noble cause, but the cooks, waiters, dishwashers, bartenders and cleanup crews for the most part did their lowly paid work while having little to no health insurance.

However, in order for them to receive such coveted coverage, all the Legislature has to do, as I have explained above, is N-O-T-H-I-N-G by simply allowing a rule to go into affect.

Even for this crew that non-action should be a no-brainer but no brains, and likely no backbones, may be the central problems.

Reflecting now on President John F. Kennedy’s most famous quote from his unforgettable inaugural speech of January 1961, I think the current Capitol crowd either never read or heard it and, on the outside chance they did, must have remembered his remarks inaccurately.

Too many of our solons think he urged “ask NOT what you can do for your country. Rather, ask what your country can do for YOU.”

Sounds harsh, and there are exceptions in both parties with Sen. Harry Coates, R-Seminole, and Rep. Lisa Billy, R-Purcell, being notable examples. But for others, their actions in general and votes specifically against the very people Kennedy asked politicians to protect reveal the painful reality of business as usual along NW 23rd Street.

In closing, I know the two tiny Democratic caucuses in the Legislature, ably led by Minority Leaders Rep. Scott Inman, D-Del City, and Sen. Sean Burrage, D-Claremore, have pledged to try and reverse Fallin’s Follies but that won’t be enough.

Aren’t there ANY among the 20 new Republican legislators elected to the House or seven to the Senate that give a rip about their most vulnerable constituents?

If so, newly minted public officials, please realize when looking in the mirror, like Pogo, you and you ALONE have the power to DO SOMETHING TO PROTECT THEIR HEALTH AND IT WON’T COST YOU A SINGLE GENERAL REVENUE DOLLAR.

However, it will take a modicum of that rarest of commodities at the Capitol – political courage. Like milk? Get some! Do you care about your fellow Sooner citizens that elected you to represent them? Then prove it.

Stand up, ask questions, and then speak up. That’s why you have your own personal microphone. Your supporters didn’t just send you to occupy a seat while waiting to be told what to do next by “The Leadership.”

If you do take action, the only negative repercussions that can happen are the loss of some or all of your following perks: Prime office space, plum committee assignments, your own executive assistant, honest conversations with lobbyists and your colleagues and, of course, you won’t be invited to the special interest dinners with the “Deciders.”

I cite these examples of retribution because I personally was on the receiving end of every one of them and more.

However, on the upside if you do show intellect and independence and thus aren’t on the guest list of VIPs for the fancy free meals, you at least won’t have to look into the eyes of the waiters and waitresses serving you while knowing, by remaining silent, you screwed them out of health care.

It’s your choice. And if you select the harder road, it won’t be all bad … just mostly.

– Cal Hobson, a Lexington, OK Democrat, served in the Oklahoma Legislature from 1978-2006, including one term as Senate President Pro Tempore. His essays appear regularly in The Oklahoma Observer.

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4 Comments

Same can be said for all State physical facilities, especially for the developmentally disabled, the mentally ill, chemical dependent, juvenile offender, child welfare children. All are deplorable places. One has been torn down, but again the shortsightedness nothing was built to replace. That was L.E. Rader. Pattern the new facilities after J. D. McCarty Center, or the Stephenson facility, O. U. Dorms(new ones being built.). At Ease.